Role Description Hi, we're Oscar. We're hiring an Associate, Process Optimization to join our Member Provider Service Optimization team. About the role: - You will work with business and technical stakeholders to solve operational problems, improve internal workflows, and represent service-delivery needs in company-wide projects. - You will support the design, optimization, and implementation of processes to guide efficiency, reduce member/provider friction, and support technology modernization. - This requires conducting root-cause analysis, documenting requirements, building project plans, analyzing performance metrics, and managing change across multiple projects simultaneously. - You will report into the Product Implementation Manager. Work Location: - This is a remote position, open to candidates who reside in: Atlanta, Georgia. - You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. Pay Transparency: - The base pay for this role is: $87,188 - $141,134 per year. - You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities - Lead the end-to-end management of operational improvements and workflow optimization projects, driving collaboration, seamless adoption and completion. - Improve readiness for strategic implementations and technology launches by developing training materials, creating clear communications, and updating internal knowledge management repositories to minimize colleague friction. - Partner with business owners to implement scalable procedural countermeasures that eliminate immediate process breaks and replace manual workarounds. - Mentor team members and promote colleagues' growth. - Compliance with all applicable laws and regulations. - Other duties as assigned. Qualifications - 3+ years of work experience in Health insurance, Health System, or related field. - 2+ years of experience with end-to-end project management. - 2+ years of experience designing and improving workflows and standing up accompanying operating and technical procedures. - A bachelor's degree or 3+ years commensurate experience. Bonus points - Bachelor's degree in Engineering, Business Administration, or other related field. - Lean Six Sigma Green Belt certification or higher. - 2+ years of experience using data software such as Excel, SQL, Python or other data analytics tools. - 1+ years of experience using AI tools to guide process optimization, task automation, or analytical insights. Benefits - Medical, dental, and vision benefits. - 11 paid holidays. - Paid sick time. - Paid parental leave. - 401(k) plan participation. - Life and disability insurance. - Paid wellness time and reimbursements.

• Lead the strategic oversight, maintenance, and optimization of the Charge Description Master (CDM) • Partner with operational, finance, clinical, compliance, and IT teams to improve revenue integrity processes • Monitor and maintain compliance with CPT, HCPCS, ICD-10, CMS, and payer requirements • Conduct CDM audits and identify opportunities for charge capture accuracy and reimbursement improvement • Manage annual and ongoing code set updates, pricing reviews, and regulatory changes • Analyze reimbursement trends and recommend operational and pricing enhancements • Support system implementations, upgrades, and integrations impacting CDM workflows, including Epic • Develop best practices and provide guidance to department leaders on CDM governance and charge capture processes • Assist with resolving billing discrepancies, denials trends, and compliance risks • Drive process improvement initiatives that enhance operational efficiency and financial performance

• Assist Traders with identifying, documenting, and escalating issues within the team • Support verification, adjustment & creation of Sport & Competition setups across environments • Help test and monitor app features to ensure proper functionality and navigation • Contribute to Compliance checks, market submissions, and post-release testing • Communicate with data providers and support ticketing • Daily review of betting content • Monitoring pre-game and in-play markets • Cross-functional assignments with Compliance, Marketing & Product • Assist Customer Experience with issue resolution • Other duties as assigned

Role Description We are hiring a Technical Operations Analyst to own inbound and outbound file operations, vendor data integrations, and reporting across our growing TPA environment. This role will serve as the central hub for file management, data movement, and operational reporting; ensuring accurate, timely, and scalable data exchange across all partners including networks, PBMs, and other vendors. This position is highly technical and data-focused, requiring strong SQL skills, deep understanding of TPA workflows, and the ability to translate business needs into reliable reporting and file solutions. Key Responsibilities - File Operations & Data Exchange Management - Own all inbound and outbound file processes across vendors (PBM, networks, medical management, etc.). - Monitor, validate, and reconcile daily file activity (eligibility, claims, accumulators, EOBs, etc.). - Ensure proper file formatting, delivery, acknowledgments, and error resolution. - Troubleshoot and resolve file failures across SFTP connections, vendors, and internal systems. - Maintain and optimize file workflows to support scalability and automation. - Vendor Integration Oversight - Serve as the primary technical contact for vendor file integrations. - Manage connectivity across SFTP platforms, APIs (where applicable), and vendor data exchanges. - Coordinate with vendors and claims system to resolve discrepancies, mapping issues, and data inconsistencies. - Ensure alignment between vendor requirements and internal system capabilities. - Reporting & Data Analytics - Build, maintain, and enhance operational and client-facing reports using SQL. - Translate business and client reporting needs into scalable data solutions. - Support reporting across eligibility, claims, accumulators, and vendor data. - Partner with internal teams (Account Management, Claims, Finance) to deliver accurate reporting insights. - Data Quality & Reconciliation - Perform cross-system data audits between claims system, vendor outputs, and internal reporting. - Identify and resolve root causes of data discrepancies (eligibility, claims, accumulators). - Ensure consistency of data across all downstream systems and vendor partners. - Develop processes to proactively monitor and improve data quality. - Implementation & Go-Live Support - Support new client implementations from a file and reporting readiness perspective. - Ensure all vendor file connections are tested, validated, and operational prior to go-live. - Partner with implementation and TechOps leadership to meet critical deadlines and dependencies. - Assist in defining file requirements, layouts, and reporting needs for new clients. - Operational Process Improvement - Develop and maintain SOPs for file management, error handling, and reporting processes. - Identify opportunities for automation, efficiency improvements, and standardization. - Support the evolution of a scalable TPA operating model as client and vendor volume grows. Qualifications - 5+ years of experience in TPA operations, healthcare data operations, EDI, or technical operations. - Strong experience managing inbound/outbound file processing across multiple vendors. - Advanced SQL skills required (data extraction, transformation, reconciliation, reporting). - Experience with file formats such as 834, 835, 837, CSV, flat files, JSON. - Hands-on experience with SFTP platforms and file automation workflows. - Strong understanding of TPA ecosystem (eligibility, claims, accumulators, PBM, network integrations). - Proven ability to troubleshoot complex data and file issues across systems and partners. - Strong analytical mindset with attention to detail and data accuracy. - Excellent communication skills with both technical and non-technical stakeholders. Benefits - Medical - Telemedicine - Dental - Vision - Life, AD&D, Disability - 401(k) - Flexible Time-off Company Description Crumdale Specialty is a diversified insurance firm providing custom, self-funded healthcare solutions to a limited distribution network of brokers, consultants, and agents nationwide. Ranked on the Inc. 5000 Fastest Growing Companies and Best Workplaces, we leverage industry expertise, superior talent, data analytics, and a disruptive mindset to manufacture, underwrite, and administer agile, transparent, and cost-saving solutions. At Crumdale, people come first. Our culture is rooted in alignment, innovation, accountability, and integrity.